scholarly journals Female Community Health Volunteers’ (FCHVs) Involvement in Improving Maternal Health, Nepal

2019 ◽  
Vol 2 (3) ◽  
pp. 250-252 ◽  
Author(s):  
Prakash Shahi
Keyword(s):  
Maternal Health ◽  
National Policy ◽  
Family Health ◽  
Emergency Obstetric Care ◽  
Skilled Birth Attendant ◽  
Neonatal Morbidity ◽  
Obstetric Care ◽  
Safe Motherhood ◽  
Care Services ◽  
Policies And Programs

Improving maternal health was one of the eight millennium development goals (MDGs) in 2000 and later included in SDG as a major agenda in 2015 which was adopted by the international community.  In Nepal, the first elected democratic government developed Health Policy in 1991 and revised in 2014 which has identified safe motherhood as a priority program and institutionalized safe motherhood as a primary health care. In order to effectively address maternal and neonatal morbidity and mortality, the Family Health Division, Department of Health Services (DoHS) developed National Safe Motherhood Long Term Plan 2002- 2017 (revised in 2006) which aimed to establish basic and comprehensive emergency obstetric care services in all districts. To complement this plan, the National Policy on SBA (2006) was developed with the aim of increasing the percentage of births assisted by a skilled birth attendant (as internationally defined) to 60 percent by 2015. Table 1 explains some historical shifts in maternal health policies and programs in Nepal.

scholarly journals A study on obstetric care in a primary health center of South Assam district, India

2018 ◽  
Vol 5 (8) ◽  
pp. 3629
Author(s):  
Ajit Kumar Dey ◽  
Debojit Chutia
Keyword(s):  
Age Groups ◽  
Multivariate Logistic Regression Analysis ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Safe Motherhood ◽  
Cross Sectional ◽  
Birth Prevalence ◽  
Care Services ◽  
Vaginal Deliveries ◽  
The Mean

Background: Maternal and child health are critically important in a country that is experiencing high infant mortality and maternal mortality. Research all over the world has suggested that one of the major solutions to this problem is availability of Emergency Obstetric Care services within the reach of people. Objectives of the study were to examine profile of mothers who have delivered in health facility during a year and the interplay of various factors in child birth and newborn outcome.Methods: Retrospective cross sectional study conducted by collecting information in predesigned format from medical records. Appropriate statistical methods and test of significance performed for qualitative and quantitative variables.Results: Out of 539 women, the majority of 42.9% were in the age group 20-25 years, the mean age (SD) of mother was 24.1 years (±4.09). Out of total 539 vaginal deliveries, 56.6% cases episiotomy was performed. 41.6% deliveries occurred from 8 AM to 4 PM. The mean birth weight was 2.830 kg SD 0.439 and low birth prevalence 16.0%. Parity with time to delivery after admission in different age groups revealed significant association (X2=66.456, p=0.000). Women aged less than 20 years are 12 times more at risk of episiotomy performed. The multivariate logistic regression analysis shows 60.67% specificity and 85.59% sensitivity in predicting episiotomy.Conclusions: From study it is evident that women report to hospital late in labor hence there is urgent need to provide quality antenatal care services at village and PHC level and augment awareness among the community for promotion of safe motherhood.

scholarly journals Male Involvement in Maternal Health Planning Key to Utilization of Skilled Birth Services in Malindi Subcounty, Kenya

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Lilian Nyamusi Nyandieka ◽  
Mercy Karimi Njeru ◽  
Zipporah Ng’ang’a ◽  
Elizabeth Echoka ◽  
Yeri Kombe
Keyword(s):  
Maternal Health ◽  
Health Planning ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Male Involvement ◽  
Rural Populations ◽  
Place Of Birth ◽  
Community Members ◽  
Care Services ◽  
Setting Process

Background.In Malindi, rural populations face challenges in accessing skilled birth services. Consequently, the majority of women deliver at home and only seek help when they have complications. This paper reports part findings from a study conducted to assess health priority setting process and its implication on availability, access, and use of emergency obstetric care services in Malindi.Methods. The study utilized qualitative methods to collect data from health personnel and maternal health stakeholders including community members. Source and method triangulation was used to strengthen the credibility of study findings. Data was categorized manually into themes around issues relating to utilization of skilled birth services discussed in this paper.Findings. Various barriers to utilization of skilled birth services were cited. However, most were linked tomwenye(the husband) who decides on the place of birth for the wife.Conclusion.Husbands are very influential in regard to decisions on skilled birth service utilization in this community. Their lack of involvement in maternal health planning may contribute as a barrier to utilization of skilled care by pregnant women. There is need to address themwenyefactor in an attempt to mitigate some of the barriers cited for nonutilization of skilled birth services.

scholarly journals The impact of a multi-level maternal health programme on facility delivery and capacity for emergency obstetric care in Zambia

2017 ◽  
Vol 13 (10) ◽  
pp. 1481-1494 ◽  
Author(s):  
Elizabeth G. Henry ◽  
Donald M. Thea ◽  
Davidson H. Hamer ◽  
William DeJong ◽  
Kebby Musokotwane ◽  
...  
Keyword(s):  
Maternal Health ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Facility Delivery ◽  
Multi Level ◽  
The Impact ◽  
Health Programme

Availability, Utilisation and Quality of Basic and Comprehensive Emergency Obstetric Care Services in Malawi

2008 ◽  
Vol 13 (5) ◽  
pp. 687-694 ◽  
Author(s):  
Eugene J. Kongnyuy ◽  
Jan Hofman ◽  
Grace Mlava ◽  
Chisale Mhango ◽  
Nynke van den Broek
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Services

scholarly journals Barriers to Emergency Obstetric Care Services in Perinatal Deaths in Rural Gambia: A Qualitative In-Depth Interview Study

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Abdou Jammeh ◽  
Johanne Sundby ◽  
Siri Vangen
Keyword(s):  
Perinatal Outcomes ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Transport Cost ◽  
Contributing Factors ◽  
Perinatal Deaths ◽  
Danger Signs ◽  
Care Services ◽  
Transport Services

Objective. The Gambia has one of the world's highest perinatal mortality rates. We explored barriers of timely access to emergency obstetric care services resulting in perinatal deaths and in survivors of severe obstetric complications in rural Gambia. Method. We applied the “three delays” model as a framework for assessing contributing factors to perinatal deaths and obstetric complications. Qualitative in-depth interviews were conducted with 20 survivors of severe obstetric complications at home settings within three to four weeks after hospital discharge. Family members and traditional birth attendants were also interviewed. The interviews were translated into English and transcribed verbatim. We used content analysis to identify barriers of care. Results. Transport/cost-related delays are the major contributors of perinatal deaths in this study. A delay in recognising danger signs of pregnancy/labour or decision to seek care outside the home was the second important contributor of perinatal deaths. Decision to seek care may be timely, but impaired access precluded utilization of EmOC services. Obtaining blood for transfusion was also identified as a deterrent to appropriate care. Conclusion. Delays in accessing EmOC are critical in perinatal deaths. Thus, timely availability of emergency transport services and prompt decision-making are warranted for improved perinatal outcomes in rural Gambia.

scholarly journals Existence and functionality of emergency obstetric care services at district level in Kenya: theoretical coverage versus reality

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Elizabeth Echoka ◽  
Yeri Kombe ◽  
Dominique Dubourg ◽  
Anselimo Makokha ◽  
Bjørg Evjen-Olsen ◽  
...  
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
District Level ◽  
Care Services

scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

scholarly journals “The midwife helped me... Otherwise I could have died” Women’s experience of professional midwifery services in rural Afghanistan.  A qualitative study in the provinces Kunar and Laghman

2020 ◽  
Author(s):  
Trude Thommesen ◽  
Hallgeir Kismul ◽  
Ian Kaplan ◽  
Khadija Safi ◽  
Graziella Van den Berg
Keyword(s):  
Professional Education ◽  
Quality Care ◽  
Emergency Obstetric Care ◽  
Newborn Health ◽  
Skilled Birth Attendant ◽  
Obstetric Care ◽  
Maternal And Newborn Health ◽  
Skin Contact ◽  
Birth Attendance ◽  
Maternal And Newborn

Abstract Background Afghanistan has one of the world’s highest maternal mortality ratios, in some areas more than 60% of women have no access to a skilled birth attendant. The main challenges for Afghan childbearing women are access to skilled birth attendance, emergency obstetric care and reliable contraception. The NGO-based project Advancing Maternal and Newborn Health in Afghanistan has supported education of midwives since 2002, according to the national plan for midwifery education. The aim of this study is to explore women´s experiences with professional midwifery care in four villages in Afghanistan covered by the project, to uncover challenges and improve services in rural and conflict-affected areas of the country. Methods An explorative case study approach was adopted. Fourteen in-depth interviews and four focus group discussions were conducted. Totally, 39 women participated; 25 who had given birth during the last six months, 11 mothers-in-laws and three community midwives in the provinces of Kunar and Laghman. Data generated by the interviews and observations was analysed through a thematic content analysis. Findings The women reported that the trained midwives’ life-saving competence, skills and care were important reasons for giving birth in a clinic, and the midwives seemed to be appreciated by many of the women, making more women to choose to give birth in the clinic. Women further appreciated midwives’ promotion of immediate skin-to-skin contact and breastfeeding. However, some women experienced rudeness, discrimination and negligence from the midwives. Moreover, disapproval from relatives, shame and problems with transport and security were important obstacles to women giving birth in the clinics. Conclusions Local recruitment and professional education of midwives as promoted by Afghan authorities and applied in the project seem successful in promoting utilization and satisfaction with maternal and newborn health services in rural Afghanistan. Nevertheless, the quality of the services is still wanting, with some women complaining of disrespectful care. There seems to be a need to focus more on communication issues during the education of midwives. An increased focus on in-service training and factors promoting quality care and respectful communication is necessary and should be prioritized.

scholarly journals “The midwife helped me... Otherwise I could have died” Women’s experience of professional midwifery services in rural Afghanistan.  A qualitative study in the provinces Kunar and Laghman

2019 ◽  
Author(s):  
Trude Thommesen ◽  
Hallgeir Kismul ◽  
Ian Kaplan ◽  
Khadija Safi ◽  
Graziella Van den Berg
Keyword(s):  
Professional Education ◽  
Quality Care ◽  
Emergency Obstetric Care ◽  
Newborn Health ◽  
Skilled Birth Attendant ◽  
Obstetric Care ◽  
Maternal And Newborn Health ◽  
Skin Contact ◽  
Birth Attendance ◽  
Maternal And Newborn

Abstract Background Afghanistan has one of the world’s highest maternal mortality ratios, in some areas more than 60% of women have no access to a skilled birth attendant. The main challenges for Afghan childbearing women are access to skilled birth attendance, emergency obstetric care and reliable contraception. The NGO-based project Advancing Maternal and Newborn Health in Afghanistan has supported education of midwives since 2002, according to the national plan for midwifery education. The aim of this study is to explore women´s experiences with professional midwifery care in four villages in Afghanistan covered by the project, to uncover challenges and improve services in rural and conflict-affected areas of the country.MethodsAn explorative case study approach was adopted. Fourteen in-depth interviews and four focus group discussions were conducted. Totally, 39 women participated; 25 who had given birth during the last six months, 11 mothers-in-laws and three community midwives in the provinces of Kunar and Laghman. Data generated by the interviews and observations was analysed through a thematic content analysis.Findings The women reported that the trained midwives’ life-saving competence, skills and care were important reasons for giving birth in a clinic, and the midwives seemed to be appreciated by many of the women, making more women to choose to give birth in the clinic. Women further appreciated midwives’ promotion of immediate skin-to-skin contact and breastfeeding. However, some women experienced rudeness, discrimination and negligence from the midwives. Moreover, disapproval from relatives, shame and problems with transport and security were important obstacles to women giving birth in the clinics.Conclusions Local recruitment and professional education of midwives as promoted by Afghan authorities and applied in the project seem successful in promoting utilization and satisfaction with maternal and newborn health services in rural Afghanistan. Nevertheless, the quality of the services is still wanting, with some women complaining of disrespectful care. There seems to be a need to focus more on communication issues during the education of midwives. An increased focus on in-service training and factors promoting quality care and respectful communication is necessary and should be prioritized.

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